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To assist our Electronic Delivery Interface (EDI) partners, UnitedHealthcare National Accounts developed these "companion" documents to describe our company-specific details for EDI transactions. They contain only supplementary instructions for the ASC X12 implementation guides and do not replace or modify the implementation guides, but should be used in conjunction with them.
Please follow the instructions in these companion documents to ensure effective and efficient processing of your transactions.
HIPAA Companion Documents
| HIPAA Standard Transactions & Code Sets Listing | View PDF |
| Transaction Type | Transaction Number |
| 1.
Eligibility Benefit Inquiry and Response Transactions UnitedHealthcare West (formerly PacifiCare) version Oxford version |
270/271 (0050101X279A1) 270/271 (004010x092) 270/271 (005010X279A1) 270/271 (005010X279A1) |
| 2. Claim Status Request UnitedHealthcare West (formerly PacifiCare) version Oxford version |
276 (005010X212) 276 (004010x093A1) 276/277 (005010X212) 276/277 (005010X212) |
| 3. Claim Status Response | 277 No instructions needed |
| 4.
Health Care Services Review & Referral Oxford version |
278 (005010X217) 278 (004010x061) 278 Referral 278 (005010X217E2) |
| 5. Premium Payments | 820 (005010X220A1) 820 (004010x095A1) |
| 6.
Benefit Enrollment and Maintenance UnitedHealthcare West (formerly PacifiCare) version |
834 (005010x221A1) 834 (004010X091A1) 834 (005010X220A1) |
| 7.
Payment and Remittance Advice UnitedHealthcare West (formerly PacifiCare) version Generic 835 File Generic Lab Only 835 File Generic Trading Partner 835 File Oxford version |
835 (005010X221) 835 (005010X221A1) 835 (005010X221) 835 (005010X221A1) 835 (005010X221A1) 835 (004010X2091A11) 835 (005010) |
| 8. Institutional Claim UnitedHealthcare West (formerly PacifiCare) version Oxford version |
837 (005010X223A2) 837 (04010x096A1) 837 (005010X222A1) 837 (005010X222A1) |
| 9. Professional Claim UnitedHealthcare West (formerly PacifiCare) version Oxford version |
837 (005010X222A1) 837 (04010x098A1) 837 (005010X223A2) 837 (005010X223A2) |
| 10. Functional Acknowledgement | 997 - No instructions needed |
| 11. Lab Result Companion Guide | Download pdf |
Non-HIPAA Companion Documents
The following documents describe our use of industry standard ASC X12 transactions that service business events not covered by the HIPAA regulations.
| Non-HIPAA Standard Transactions & Code Sets Listing | View PDF |
| Transaction Type | Transaction Number |
| 1. Hospital Admission Notification Transactions | 278N (005010X216) |
This material is provided on the recipient's agreement that it will only be used for the purpose of describing UnitedHealthcare National Accounts products and services to the recipient. Any other use, copying or distribution without the express written permission of UnitedHealthcare National Accounts is prohibited. - 02/25/11